Provider Demographics
NPI:1356074421
Name:BROOKS, SHANNON (MSN, APRN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MSN, APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 PRESTON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3413
Mailing Address - Country:US
Mailing Address - Phone:214-456-2793
Mailing Address - Fax:
Practice Address - Street 1:7120 PRESTON RD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3413
Practice Address - Country:US
Practice Address - Phone:214-456-2793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141189363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics